Soaring rates of liver disease will only be reduced by charging more for alcohol and restricting its availability, experts argue

Wine for under £3 per bottle on supermarket shelves. Doctors in a Lancet study argue that shops must be made to charge more for alcohol if liver disease is to be cut. Photograph: Sean Spencer / Alamy/Alamy

Up to 250,000 people could die because of alcohol over the next 20 years unless ministers take strong action to tackle Britain's chronic drink problems, leading doctors are warning.

The prediction comes in edition of the Lancet medical journal by three senior experts on alcohol, two of whom are advising the coalition on how to reduce drink-related harm.

In a scathing critique of the government's approach to alcohol, the trio accuse ministers of pursuing policies that will make no difference to the soaring rates of drink-related liver disease. Ministers, including the health secretary, Andrew Lansley, are "too close" to the drinks industry and too reluctant to take effective steps, they say.

They welcome the government's decision to continue raising the cost of drink at 2% above inflation. However, "plans to ban the sale of alcohol beverages below cost (duty plus VAT) and to increase duty on beer over 7.5% strength are inconsequential because of the tiny fraction of sales that fall into either category", write Dr Nick Sheron, Professor Ian Gilmore and Professor Chris Hawkey.

"These policies suggest that the government remains too close to the industry and lacks clear aspiration to reduce the impact of cheap, readily available, and heavily marketed alcohol on individuals and on society," they write.

Sheron, a clinical hepatologist, and Gilmore, the chairman of the Alcohol Health Alliance of medical groups and charities, both serve on the Department of Health's Responsibility Deal Alcohol Network along with representatives of the drinks industry.

The doctors estimated how many lives would be saved or lost in England and Wales by 2031, depending on whether ministers pursued a strategy of only minimal change or robust regulation, over and above those that are already expected on current trends. Liver deaths have more than doubled in the UK since 1986.

Introducing a minimum price per unit of alcohol and adopting a French-style ban on drink advertising and sponsorship could together see liver death rates fall from the existing estimate of 18,000-30,000 to just 2,500 by 2019, they calculate. But allowing the current upward trajectory of such mortality to continue unchecked would lead to 77,000 extra liver deaths by 2031.

However, the wider harms from alcohol, such as deaths from accidents and violence, could mean that as many as 160,000 to 250,000 lives are lost or saved over the next two decades, depending on whether effective action is taken or not.

Historical precedents, such as action to tackle the gin epidemic of 1730-50 and the Defence of the Realm Act in 1914, show that raising the price of alcohol and restricting its availability are the two proven ways of reducing drink-related harm, the authors argue. Yet ministers, they say, have rejected major changes in both areas.

"How many more people have to die from alcohol-related conditions, and how many more families devastated by the consequences before the government takes the situation as seriously as it took the dangers of tobacco?" asked Sir Richard Thompson, president of the Royal College of Physicians, which represents hospital doctors.

He accused ministers of ignoring international evidence showing that price rises and reduced availability are the best two ways to reduce consumption of alcohol. "Just as the government would expect us to treat our patients with effective medicines, we expect the government to take much stronger action to protect people from alcohol-related harm." he said. "When will that happen?"

The Department of Health rejected the doctors' views. "The government has wasted no time in taking tough action to tackle problem drinking, including plans to stop supermarkets selling below-cost alcohol and working to introduce a tougher licensing regime," said a spokeswoman.

Reforming public health would also help, and there will be a new alcohol strategy in the summer, she added.